High Blood Pressure and Its Association With Incident Diabetes Over 10 Years in the Korean Genome and Epidemiology Study (KoGES)

Cho, Nam H.; Kim, Kyoung Min; Choi, Sung Hee; Park, Kyong Soo; Jang, Hak Chul; Kim, Sung Soo; Sattar, Naveed; Lim, Soo

doi:10.2337/dc14-1931

Cited by 42 publications

(30 citation statements)

References 35 publications

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“…In the current study, the prevalence of diabetes was higher in patients with PA than it is in the general population; this held true for all 10-year subgroups aged between 30 and 69 years and for both men and women. Because it has been established that hypertension is causally associated with diabetes (32)(33)(34), age-and sex-matched cohorts of 230 patients with PA and 230 with EHT were compared; a significantly higher prevalence of diabetes was found in those with PA than in those with EHT. However, no such significant difference was identified when PA patients matched for BMI or without suspected SH were compared with patients with EHT.…”

Section: Discussionmentioning

confidence: 99%

High Prevalence of Diabetes in Patients With Primary Aldosteronism (PA) Associated With Subclinical Hypercortisolism and Prediabetes More Prevalent in Bilateral Than Unilateral PA: A Large, Multicenter Cohort Study in Japan

et al. 2019

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To investigate the prevalence and causes of diabetes in patients with primary aldosteronism (PA) in a multi-institutional cohort study in Japan. RESEARCH DESIGN AND METHODS The prevalence of diabetes was determined in 2,210 patients with PA (diagnosed or glycated hemoglobin [HbA 1c ] ‡6.5% [ ‡48 mmol/mol]; NGSP) and compared with that of the Japanese general population according to age and sex. In 1,386 patients with PA and clear laterality (unilateral or bilateral), the effects of plasma aldosterone concentration (PAC), hypokalemia (<3.5 mEq/L), suspected subclinical hypercortisolism (SH; serum cortisol ‡1.8 mg/dL after 1-mg dexamethasone suppression test), and PA laterality on the prevalence of diabetes or prediabetes (5.7% £ HbA 1c <6.5% [39 mmol/mol £ HbA 1c <48 mmol/mol]) were examined. RESULTS Of the 2,210 patients with PA, 477 (21.6%) had diabetes. This prevalence is higher than that in the general population (12.1%) or in 10-year cohorts aged 30-69 years. Logistic regression or x 2 test revealed a significant contribution of suspected SH to diabetes. Despite more active PA profiles (e.g., higher PAC and lower potassium concentrations) in unilateral than bilateral PA, BMI and HbA 1c values were significantly higher in bilateral PA. PA laterality had no effect on the prevalence of diabetes; however, the prevalence of prediabetes was significantly higher in bilateral than unilateral PA. CONCLUSIONS Individuals with PA have a high prevalence of diabetes, which is associated mainly with SH. The prevalence of prediabetes is greater for bilateral than unilateral PA, suggesting a unique metabolic cause of bilateral PA.

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Section: Discussionmentioning

confidence: 99%

High Prevalence of Diabetes in Patients With Primary Aldosteronism (PA) Associated With Subclinical Hypercortisolism and Prediabetes More Prevalent in Bilateral Than Unilateral PA: A Large, Multicenter Cohort Study in Japan

et al. 2019

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“…In African Americans and Caucasians aged 35 to 54 years, higher blood pressure was associated with a higher risk of diabetes than normal blood pressure (systolic blood pressure/diastolic blood pressure, <120/80 mm Hg) [ 37 ]. In a community-based cohort study of Korean adults, people with prehypertension (120 to 139/80 to 89 mm Hg), stage 1 hypertension (140 to 159/90 to 99 mm Hg), and stage 2 hypertension (≥160/100 mm Hg) had a higher risk of developing diabetes than people in the normal range (<120/80 mm Hg) [ 38 ]. Additionally, the 2017 American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines suggested that a blood pressure target of less than 130/80 mm Hg may be reasonable [ 39 ].…”

Section: Discussionmentioning

confidence: 99%

Development and Validation of the Korean Diabetes Risk Score: A 10-Year National Cohort Study

Lee

Song

et al. 2018

Diabetes Metab J

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BackgroundA diabetes risk score in Korean adults was developed and validated.MethodsThis study used the National Health Insurance Service-National Health Screening Cohort (NHIS-HEALS) of 359,349 people without diabetes at baseline to derive an equation for predicting the risk of developing diabetes, using Cox proportional hazards regression models. External validation was conducted using data from the Korean Genome and Epidemiology Study. Calibration and discrimination analyses were performed separately for men and women in the development and validation datasets.ResultsDuring a median follow-up of 10.8 years, 37,678 cases (event rate=10.4 per 1,000 person-years) of diabetes were identified in the development cohort. The risk score included age, family history of diabetes, alcohol intake (only in men), smoking status, physical activity, use of antihypertensive therapy, use of statin therapy, body mass index, systolic blood pressure, total cholesterol, fasting glucose, and γ glutamyl transferase (only in women). The C-statistics for the models for risk at 10 years were 0.71 (95% confidence interval [CI], 0.70 to 0.73) for the men and 0.76 (95% CI, 0.75 to 0.78) for the women in the development dataset. In the validation dataset, the C-statistics were 0.63 (95% CI, 0.53 to 0.73) for men and 0.66 (95% CI, 0.55 to 0.76) for women.ConclusionThe Korean Diabetes Risk Score may identify people at high risk of developing diabetes and may be an effective tool for delaying or preventing the onset of condition as risk management strategies involving modifiable risk factors can be recommended to those identified as at high risk.

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“…In the Korean genome and epidemiology study, after adjusting for some anthropometric factors, family history of diabetes and biochemical parameters, people with baseline hypertension were at higher risk of developing diabetes than normotensive population. Specifically, in the Grade 1 hypertension group(SBP/DBP 140-159/90-99 mmHg), people had a 26% increased risk of developing diabetes (HR 1.26; 95% CI, 1.04-1.54), in the Grade 2 and 3 hypertension group(SBP/DBP ≥ 160/100 mmHg), people increase their risk of diabetes by 60% (HR 1.60 ; 95% CI,1.30-1.96) [32]. In a population-based prospective cohort study among 10,038 participants in Korea, the researchers found that compared with subjects with normal baseline blood pressure, people with baseline hypertension had a 51% higher risk of developing diabetes [33].…”

Section: Discussionmentioning

confidence: 99%

Association of hypertension and incident diabetes in Chinese adults: a retrospective cohort study using propensity-score matching

Chen

et al. 2020

Preprint

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Background Previous studies have revealed that hypertension is one of major risk factors of incident diabetes. However, reliable quantification of the relationship between hypertension and diabetes risk is limited, especially in Chinese people. We aimed to investigate the association between hypertension and risk of incident diabetes in a large cohort of Chinese population. Methods This was a retrospective propensity score-matched cohort study. We enrolled 211809 Chinese adults without diabetes at baseline between 2010 and 2016. The target independent and dependent variable were hypertension at baseline and incident diabetes during follow-up respectively. The one to one propensity score matching using a non-parsimonious multivariable logistic regression was conducted to balance the confounders between 28,946 hypertensive patients and 28,946 non-hypertensive participants. The doubly robust estimation method was used to investigate the association between hypertension and incident diabetes. Result After propensity-score matching, the cumulative incidence of diabetes among hypertensive and non-hypertensive participants were 1627.690 per 100,000 person-years and 1414.422 per 100,000 person-years, respectively. In the propensity-score matching cohort, compared to the non-hypertensive participants, the risk of incident diabetes increased by 14.0% among hypertensive subjects (HR = 1.140, 95% confidence interval (CI): 1.058–1.229, P = 0.00063). After adjusting for the demographic and clinical covariates, diabetes risk increased by 13.1% in the hypertensive group (HR = 1.131, 95%CI: 1.049–1.220, P = 0.00143). And diabetes risk increased by 15.4% among hypertensive subjects after adjusting for the propensity score (HR = 1.154, 95%CI:1.070–1.244, P = 0.00019).In the subgroup analysis, compared to non-hypertensive participants with low propensity score, the risk of incident diabetes increased by 2.6 times among hypertensive patients with high propensity score (HR = 3.610,95%CI: 2.604–5.005,P < 0.00001). In the sensitivity analysis, the risk of diabetes in the hypertensive group increased by 11.7% in the original cohort (HR = 1.117༌95%CI: 1.044–1.196,P = 0.00134) and 19.9% in the weighted cohort(HR = 1.199༌95%CI: 1.149–1.250,P < 0.00001), respectively. Conclusion Hypertension was associated with a 13.1% increase in the risk of developing diabetes in Chinese adults. Additionally, compared to non-hypertensive participants with low propensity score, the risk of incident diabetes increased by 2.6 times among hypertensive patients with high propensity score.

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High Blood Pressure and Its Association With Incident Diabetes Over 10 Years in the Korean Genome and Epidemiology Study (KoGES)

Cited by 42 publications

References 35 publications

High Prevalence of Diabetes in Patients With Primary Aldosteronism (PA) Associated With Subclinical Hypercortisolism and Prediabetes More Prevalent in Bilateral Than Unilateral PA: A Large, Multicenter Cohort Study in Japan

High Prevalence of Diabetes in Patients With Primary Aldosteronism (PA) Associated With Subclinical Hypercortisolism and Prediabetes More Prevalent in Bilateral Than Unilateral PA: A Large, Multicenter Cohort Study in Japan

Development and Validation of the Korean Diabetes Risk Score: A 10-Year National Cohort Study

Association of hypertension and incident diabetes in Chinese adults: a retrospective cohort study using propensity-score matching

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